Pauline Gloria Smith, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301105860 Issued in MI

Practice address

5221 Gullen Mall Ste 552
Detroit, MI 48202-3919

Phone

(734) 764-6875

NPI assigned

Jun 11, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: pauline.smith.1@15156.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1164835740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5221 GULLEN MALL STE 552",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5221 GULLEN MALL STE 552",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023919",
            "telephone_number": "734-764-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "PAULINE",
        "middle_name": "GLORIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301105860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ondrasha Mona Smith
• Patricia Smith
• Patricia Smith
• Paul Smith
• Paulette Smith
• Quinton David Smith, MD
• Rachel Marion Smith
• Raesean Lamonte Smith
• Raymond Smith
• Raynard Brett Smith

• Psychiatry Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.